Study of reactivity pattern of hormone receptors in patients with breast cancer at a tertiary care hospital, Aurangabad, India

Greeshma Ann George, S. S. Mulay, Neha Borde, Philips Antony


Background: Breast cancer is one of the most common malignancies affecting the female population worldwide. Prognosis and management of breast cancer are influenced by variables such as stage, grade, and hormone receptor status. Tumours that express ER and/or PR have a better prognosis and most of them respond well to hormonal therapy. In addition to hormone receptors, HER2 has emerged in recent years as an important independent predictive marker.

Methods: All surgically operated female cases of breast carcinoma which were submitted for immunohistochemistry test for estrogen, progesterone and human epidermal growth factor receptor-2 in the Department of Pathology, MGM Medical College, Aurangabad for the duration of December 2015 to October 2017 were included in this prospective study. A total of 50 patients were taken up for the study.

Results: The maximum age of the patients were in the 4th -5th decade and were mostly premenopausal. The tumour was maximum involving the right breast, upper outer quadrant and were BI-RADS 4. Majority were grade 2 and were invasive ductal carcinoma. Hormone receptor status showed ER positivity 48%, PR positivity 46% and HER2 positivity 28%.

Conclusions: So, to conclude, immunohistochemical analysis of ER, PR and HER2 receptors is widely available at a reasonable cost and provides valuable prognostic, predictive and therapeutic information. Although we could see different patterns of hormonal receptor status, irrespective of the histological grade, type and lymph node status in our study, HER2 testing along with ER/PR status should be performed routinely in all the patients diagnosed of breast cancer as this will help the clinicians to manage the patients further.


Breast cancer, Estrogen receptor, Grade, Human epidermal growth factor receptor 2, Hormone receptor, Progesterone receptor

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Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, et al. Globocan 2012 v1.1, Cancer incidence and mortality worldwide: IARC cancerbase no. 11(internet). Lyon, France: International agency for western cancer; 2014.

Carey LA, Perou CM, Livasy CA, Dressler LG, Cowan D, Conway K, et al. Race, breast cancer subtypes, and survival in the Carolina Breast Cancer Study. JAMA. 2006 Jun 7;295(21):2492-502.

Azizun-Nisa BY, Raza F, Kayani N. Comparison of ER, PR and HER-2/neu (C-erb B 2) reactivity pattern with histologic grade, tumor size and lymph node status in breast cancer. Asian Pac J Cancer Prev. 2008 Oct;9(4):553-6.

Vinay Kumar V, Abul K. Abbas, Nelson Fausto. Robbins and Cotran Pathologic Basis of Disease. 7th ed. Philadelphia, Elsevier 2007;1136-1137.

Suvarchala SB, Nageshwararao R. Carcinoma Breast-Histopathological and hormone receptors correlation. J Biosci Tech. 2011:2(4);340-48.

Perou CM, Sørlie T, Eisen MB, Van De Rijn M, Jeffrey SS, Rees CA, et al. Molecular portraits of human breast tumours. nature. 2000 Aug;406(6797):747-52.

Cao MD, Lamichhane S, Lundgren S, Bofin A, Fjøsne H, Giskeødegård GF, et al. Metabolic characterization of triple negative breast cancer. BMC cancer. 2014 Dec;14(1):941.

Bloom HJ, Richardson WW. Histological grading and prognosis in breast cancer: a study of 1409 cases of which 359 have been followed for 15 years. BJC. 1957 Sep;11(3):359.

Qureshi A, Pervez S. Allred scoring for ER reporting and it's impact in clearly distinguishing ER negative from ER positive breast cancers. J Pakistan Medical Association. 2010;60(5):350.

M. Elizabeth, H. Hammond. American Society of Clinical Oncology/College of American Pathologists Guideline Recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer; J Clin Oncol, ASCO Special Article, 28(16),2010;2785-95.

Antonio C Wolff. Recommendations for Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer: American Society of Clinical Oncology/College of American Pathologists Clinical Practice Guideline Update; J Clin Oncol, ASCO Special Article, 2013;31(31);3997-4014.

Devi1 PU, Uma P, Bhagya LA. A study of correlation of expression of ER, PR and HER2/neu receptor status with clinico-pathological parameters in breast carcinoma at a tertiary care center. Int J Res Med Sci. 2015 Jan;3(1):165-72.

Hussain Gadelkarim Ahmed, Mohammed Ali Al-Adhraei and Abdullah Kasim Al-Thobhani, Correlations of Hormone Receptors (ER and PR), Her2/neu and p53 Expression in Breast Ductal Carcinoma Among Yemeni Women, The Open Cancer Immunol J, 2011 Dec 20;4(1).

Almasari NM, Hamad MA. Immunohistochemical evaluation of human epidermal growth recptor 2 and estrogen and progesterone receptor in breast carcinoma in Jordan, Breast cancer research 2005, 7(5): R598-R604.

Azizun-Nisa BY, Raza F, Kayani N. Comparison of ER,PR and HER2/neu (C-erb B2) reactivity pattern with histologic grade, tumour size and lymph node status in breast cancer. Asian Pac J Cancer Prev. 2008;9(4):553-6.

Suvarchala SB, Nageshwararao R. Carcinoma Breast-Histopathological and hormone receptors correlation. J Biosci Tech. 2011:2;340-8.

Sandhu DS, Sandhu S, Karwasra RK, Marwah S. Profile of breast cancer patients at a tertiary care hospital in North India. Indian J. Cancer. 2010;47(1):16-22.

Pervaiz F, Rehmani S, Majid S, Anwar H. Evaluation of hormone receptor status (ER/PR/HER2-neu) in breast cancer in Pakistan. FEC. 2015 Jul 1;99:47.

Darbre PD. Recorded Quadrant Incidence of Female Breast Cancer in Great Britain Suggests a Disproportionate Increase in the Upper Outer Quadrant of the Breast; Anticancer Research 2005;25:2543-50.

Jain SA, Aggrawal L, Ameta A, Nadkarni S, Goyal A, Ranjan D, et al. Study of ER, PR & HER-2/NEU reactivity pattern in the patient of Breast Cancer in northern part of india. IOSR J Dental Med Sci. 2014;13:9-19.

Ambroise M, Ghosh M, Mallikarjuna VS, Kurian A. Immunohistochemical Profile of Breast Cancer Patients in a tertiary care hospital in South India. Asian Pacific J Cancer Prev. 2011;12(3):625-9.

Ghosh J, Gupta S, Desai S, Shet T, Radhakrishnan S, Suryavanshi P, et al. Estrogen, progesterone and HER2 receptor expression in breast tumours of patients, and their usage of HER2 targeted therapy, in a tertiary care centre in India. Indian J Cancer 2011;48(4):391-6.